Radioactive Materials Laboratory Survey Report (RPS-5)

Radioactive materials workers use this form to document surveys performed in the lab.


  • A documented survey (using this form) is required at least once every month radioactive materials are used. 
  • The Survey Report is due at Environment, Health & Safety on the first day of the month to report the status of the lab during the previous month. 
  • If no radioactive material is used during the month, no survey is required. Indicate that the lab was inactive and submit the form.

Need Help Completing the Form?

Send email, phone or submit a question

EHS avatar

Environment, Health & Safety Radiation Safety

Service Building, 220 Winspear Ave.

Phone: 716-829-3281


(We'd like to respond to you.)

Form Facts

Form Type: Formstack document

Requirements: none

Updated: 06/26/2017

Owner: Environment, Health & Safety